细菌性腹泻患儿粪便标本病原微生物检验结果及耐药性

Pathogenic Microorganism Detection and Drug Resistance of Fecal Samples from Children with Bacterial Diarrhea

目的分析细菌性腹泻患儿粪便标本病原微生物检验结果及耐药性。方法选取2017年3月至2019年10月武陟县人民医院收治的164例细菌性腹泻患儿作为研究对象,接受粪便标本病原微生物检验、耐药性试验,并选取同期129例健康体检儿童进行影响因素分析。结果164份粪便标本共检测出130株病原微生物,其中志贺菌60株,占比46.15%;致泻大肠埃希菌30株,占比23.08%;弧菌属20株,占比15.38%;嗜水气单胞菌11株,占比8.46%;沙门菌9株,占比6.92%。耐药性分析结果显示,各类病原微生物对不同抗生素均具有一定耐药性,其中弧菌属、嗜水气单胞菌对氨苄西林耐药性较强,均>80%;致泻大肠埃希菌对头孢曲松钠、氨苄西林耐药性较强,均>65%;多因素logistic回归分析结果显示,儿童饭前及便后洗手、餐具消毒、及时处置剩饭、保持手指甲卫生为儿童细菌性腹泻的保护因素,室内有苍蝇、蟑螂为儿童细菌性腹泻发生的危险因素(P<0.05)。结论细菌性腹泻患儿粪便标本的主要病原微生物为志贺菌、致泻大肠埃希菌,且各类病原微生物对不同抗生素均具有一定耐药性,临床应根据病原微生物药敏试验结果,选用敏感抗菌药物。

Objective To analyze the detection results and drug resistance of pathogenic microorganisms in fecal samples of children with bacterial diarrhea.Methods A total of 164 children with bacterial diarrhea in WuZhixian People’s Hospital from March 2017 to October 2019 were selected as the research objects.Pathogenic microorganism test and drug resistance test were conducted on fecal samples,and 129 healthy children with physical examination were selected for influencing factors analysis.Results A total of 130 pathogenic microorganisms were detected in 164 fecal samples,including 60 strains of Shigella(46.15%),30 strains of diarrhea Escherichia coli(23.08%),20 strains of Vibrio(15.38%),11 strains of Aeromonas hydrophila(8.46%)and 9 strains of Salmonella(6.92%).The results of drug resistance analysis showed that all kinds of pathogenic microorganisms had certain resistance to different antibiotics.Among them,Vibrio and Aeromonas hydrophila had strong resistance to ampicillin,both>80%.The diarrhea Escherichia coli had strong resistance to ceftriaxone sodium and ampicillin,both>65%.The results of multivariate logistic regression analysis show that washing hands before and after meals,disinfecting tableware,timely disposal of leftovers and keeping fingernails sanitary were the protective factors for children’s bacterial diarrhea,and indoor flies and cockroaches were the risk factors for the occurrence of bacterial diarrhea in children(P<0.05).Conclusion The main pathogenic microorganisms in the fecal samples of children with bacterial diarrhea were Shigella and Escherichia coli,and all kinds of pathogenic microorganisms had certain drug resistance to different antibiotics.Therefore,sensitive antibacterial agents should be selected according to the results of drug sensitivity test of pathogenic microorganisms in clinic to improve the clinical effect.